Michigan Medicare Supplement Plans (Medigap)
Medicare Supplement Plans are available in Michigan to provide extra insurance benefits and work in conjunction with your Traditional Medicare coverage.
These insurance plans were created to provide coverage for out of pocket (OOP) costs associated with deductibles, coinsurance and copayments.
Michigan Medicare Benefits Broken Down
- Traditional Medicare Part A: is your hospital benefits. It provides coverage for any inpatient admissions, procedures, blood work, diagnostic imaging and medications while hospitalized.
- Medicare Part B: is your outpatient benefits. It provides coverage for any treatment with your physicians. Additionally, it covers ER visits, outpatient procedures, lab work and diagnostic imaging/testing.
- Medicare Part C: aka a Medicare Advantage Plan. This plan is considered a Medicare Replacement Plan as it takes over coverage for your Medicare Part A and Part B benefits.
- Medicare Part D: is your prescription drug coverage.
Michigan offers ten different letter plans that are considered Medicare Supplement Plans. The sole purpose of these plans is to provide added coverage to coincide with Traditional Medicare.
The difference with Medicare and Medicare Supplement Plans is that supplemental insurance provides extra coverage to some of the deductibles, copays, coinsurance and other medical expenses that straight Medicare won’t cover.
What Does Medicare Cover in Michigan
Medicare Part A covers your hospitalization benefits at 80% and Medicare Part B covers your outpatient medical treatments at 80%. The remaining 20% not covered by Medicare is left for the insured to be financially responsible for.
Based on your individual healthcare needs, Michigan residents can help cut down their OOP costs by obtaining a Medicare Supplement Plan.
Requirements for Michigan Medicare Supplement Plans
To be considered eligible for a Medicare Supplement Plan you must already be 65 years of age and already carrying Medicare Part B health insurance. You have a total of 7 months in what is called your Open Enrollment Period (OEP) that starts the 3 months prior to your 65th birthday.
Failing to enroll during your OEP results in what is known as the Part B penalty. The penalization increases your premium by 10% for each full 12-month period without coverage. This will automatically be included in your $134.00 a month premium. To avoid any additional OOP costs you want to make sure to enroll during your OEP.
If you’re under the age of 65 and are inquiring about Medicare benefits, to be considered eligible you need be disabled, currently receiving Social Security Disability benefits or have have end stage renal disease.
Additionally, those currently receiving Railroad Retirement Benefits will automatically be enrolled in Medicare Parts A and B after 24 months.
There are no laws that require the private insurance companies to offer Medicare Supplement plans however you’re in luck if you reside in Michigan. State law allows for supplemental insurance plans being offered to disabled Michiganders.
As most individuals who are considered disabled live on a fixed income, a Medicare Supplement Plan can help you save money in the long run. Let us help save you money by calling today!
How to Apply for Medicare Supplement Plan in Michigan
The 7 month OEP is the best time to enroll in a Medicare Supplement Plan. OEP begins the 1st day of the month after turning 65 and currently carrying Medicare Part B. You then are eligible for the next 6 months to be in the OEP window.
For example, if your birthday was October 31st and your Medicare Part B effective date was November 3rd, then your OEP begins December 1st.
During this time you are automatically granted what is called the Guaranteed Issue (GI) right. The GI right ensures your eligibility for a Medicare Supplement Plan.
Regardless of any pre-existing medical conditions the insurance carrier’s are unable to deny coverage, increase your premium rate or perform underwriting.
To avoid excessive OOP costs added to your monthly premiums, it’s necessary to enroll during your OEP period to ensure your GI.
Medicare Supplement Plan Premiums in Michigan
Each of the individual insurance providers in the different states determine their premium charges . The different determining factors for premium cost include your age, gender and location. So a 68 year old male living in Detroit will have different premiums than a female living in Ann Arbor.
And if your disabled under 65 and living in Grand Rapids, MI, your premium will be completely different from that of a senior citizen’s.
Additionally, there are 3 different pricing methods are used. Community rated pricing, issue-age rated pricing, or attained-age-rated pricing are the three different pricing methods and you can here for more info.
The Best Medicare Supplements in Michigan
The individual, private insurance companies in each state will offer these plans. Regardless of which carrier you go with, they offer the exact same 10 letter plans with the insurance benefits remaining the same.
The only variation between the insurance plans are what the carrier decides to charge for the monthly premiums. Of all the Medicare Supplement Plans, the top 3 best coverage is offered with Plans F, G and N.
Is one of the most popular as it is one of the cheapest Supplement Plans. It’s considered a cost-sharing plan. It covers the deductible of Medicare Part A and requires a small copayment for office and ER visits. With it being less expensive it offers less benefits than the other top 2 Medicare Supplement Plans.
Considered the most popular of the Supplement Plans, Plan F provides the best overall, coverage. This plan provides 100% coverage of Medicare Part A and Medicare Part B’s deductibles.
It also provides coverage for the remaining 20% leftover from Part A and Part B costs not covered by straight Medicare. Additionally, it covers Medicare Part B coinsurance and copayments and has the added bonus of also foreign travel coverage.
Plan F High Deductible
Provides the exact same benefits as Medicare Supplement Plan F however, with a higher deductible cost but lower monthly premium.
Medicare Supplement Plan G is very similar to Medicare Supplement Plan F. It offers the same benefits with the only difference being no Medicare Part B deductible coverage which as of 2018 is $183.
It does however, cover excess charges which physicians in Michigan are permitted to up charge.
Medicare Advantage Plans in Michigan
Medicare Part C or Medicare Advantage Plans are also offered by the individual insurance companies. While covering the same medical expenses as Original Medicare it generally comes with certain policy limitations.
While premiums are typically cheaper than a Medicare Supplement Plan, overtime your OOP costs are higher. Most seniors end up with better coverage and less OOP monthly expenses by choosing a Medicare Supplement Plan over a Medicare Advantage Plan.
Michigan Prescription Drug Plans for Medicare
By obtaining a PDP, you’re able to forgo the expensive OOP costs associated with prescription medications. And without PDP coverage being offered by Medicare, you’re liable to spend thousands of dollars on drug costs alone.
The benefit of having a PDP is it provides coverage for any OOP expenses associated with prescription medications and gives you peace of mind every time your doctor writes you a RX.
Additionally, without having a PDP you expose yourself to even more OOP costs as there is a Part D penalty that starts after your 7 month initial enrollment period (IEP). Once your IEP has expired, depending on how long you go without drug coverage, your month premium is increased depending on how long you went without drug coverage.
For the least amount of OOP costs but the most comprehensive coverage, the best option for seniors residing in Michigan is a combination of:
- Traditional Medicare
- a Medicare Supplement Plan
- and a Prescription Drug Plan
Sign Up for Medicare in Michigan Online
Signing up for a Medicare Supplement Plan online is easy! Simply fill out our online form and one of our licensed insurance agents can help.
They will eagerly answer any questions you may have, discuss the different policies and compare rates, making the sign-up process easy and stress-free! As always our services are free of charge. Call or fill out our online rate form here.
Michigan Medicare Help
Whether you decide to go with just straight Medicare or you get a combination of Medicare, a PDP and supplemental insurance, OOP expenses associated with health insurance can be exponential.
As a senior citizen on a fixed income it’s important you know there is financial help available to you. When it comes to the federal Medicare program, there are state Medicare savings programs available to provide financial assistance for those that qualify. Michigan residents can find help on the SHIP website here.
Michigan KFF Facts
The total number of Medicare beneficiaries in 2015 was just under 2 million in the state of Michigan. That’s 19% of the states total population. In 2016, an average of 19% were disabled and the other 81% had reached the age of 65.
The total amount of Medicare beneficiaries that were disabled with ESRD was just under 7,700. The total amount of beneficiaries that were not disabled, but reached age 65, was just under 7,900.
Michigan Medicare FAQs
- Does Medicare cover Assisted Living in Michigan? Unfortunately Medicare does not cover any Assisted Living Facilities.The only facilities covered by Medicare are the short-term nursing care facilities. If you plan on living in an ALF this will be considered an OOP cost.
- Did Michigan expand Medicare? Yes, Michigan is one a many states to have approved Section 1115 waivers for the Medicaid expansion.
- Does Medicare cover dentures in Michigan? Medicare will only covers dental procedures if they are medically necessary for a patient’s health. Oral surgery required for jaw fractures or any treatment secondary to complications from dental procedures are examples in which Medicare would cover. Unfortunately, cosmetic dental procedures, including dentures aren’t covered by Traditional Medicare. Some Medicare Advantage plans cover some dental services, including dentures. Call us today and we can help find an insurance policy tailored to your healthcare needs, including dentistry if so desired.